Amos Smadja-Amyotrophic Lateral Sclerosis-(Israel)-Update on April 26th, 2017

Name: Amos Smadja
Sex: Male
Nationality: Israeli
Age: 24Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis 2. After tracheotomy 3. Respiratory tract infection
Date of Admission: November 25th, 2016
Treatment hospital/period: Wu Medical Center/16days

Before treatment:
Amos’ legs were weak and he had muscular atrophy 4 years ago without any reason. The disease progressed fast. In 2012 he had MRI and EMG examinations and he was diagnosed with ALS. His disease was getting worse day by day. He was unable to walk 2 years ago so he used a wheelchair. His arms became weak. In the last half 2006, he was unable to raise his arms. He received a tracheotomy 4 months ago due to breathlessness He also wore a breathing machine (TV: 500, BR: 14, Ins.T:1.0, Peep: 5, C.D.A:20, low IPA: 9, higIPA: 50). He was unable to talk but was able to drink and eat food. At present he is unable to move his limbs, take a shower, eat without help, put on clothes and so on. He is able to chew food and swallow. He wanted  better treatment, so he came to our hospital.
His mental state, diet and sleep patterns are all good. His bladder and bowel functions are both normal.

Admission PE:
Bp: 130/75mmHg, Hr: 120/min, breathing rate: 19/mim, body temperature: 37 degrees, height: 184cm, weight: 70kg. Nutrition status is normal and he has normal physical development. The center of his neck has a fixed tube from the tracheotomy to connect to a breathing machine. There is no injury or bleeding spots of his skin and mucosa, no blausucht, no throat congestion, and his tonsils do not have swelling. Chest develop is normal, the respiratory sounds in both lungs are clear(mechanical ventilator assisted), there is no dry or moist rales. The heart beat is powerful, with no obvious murmur in the valves. The abdomen is flat, with no masses or tenderness. His liver and spleen are normal and there are no abnormal sounds in the stomach. There is no swelling in either leg.

Nervous System Examination:
The patient is alert and his spirits are good. His memory, orientation and calculation ability are normal. Both pupils are equal in size and round, diameter of 3mm, react well to light and the eyeballs can move freely. There is no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, his tongue is in middle with mild tongue muscle atrophy. Showing of the teeth test is normal. The patient can bulge the cheek with some air leakage. His chewing ability is good and the soft palate can lift strongly. The patient can close eyes as normal. Bilateral supraspinatus, infraspinatus muscles, four limbs muscles, bilateral thenar muscles, hypothenar muscles and interosseous muscles in the both hands show wasting. His neck muscles are soft, his head movement and shrug powers show weakness. Muscle strength of arms and legs is at level 0, but muscle tension is normal. The bilateral bicipital tendon reflex is active, the patellar tendon reflex of the legs and Achilles tendon reflex are not present. Hoffmann sign of both sides are negative, the Babinski sign are neutral. Both hands can not finish the finger to nose test, the fast alternative test and finger to finger test because of the muscle strength. Meningeal irritation sign is negative.

After admission, he was diagnosed with Amyotrophic Lateral Sclerosis. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged motor nerves, replace dead nerves, nourish nerves and improve blood circulation. He also had rehabilitation training.     

After 16 days of treatment, his tidal volume was increased from 400ml to 450-500ml, The fingers of both hands showed active movement, the hand grip strength for both hands was at level 2. There is obvious muscular contraction in the lower limbs with the muscle power  at level 1. His spirit and energy are both great.



Dear   Dr.  Wang
The following is a reference to your letter
1. Amos feels good in general
2. Good input
3. The palms of the hands are open
4. After treatment the head and neck have straightened out
5. We perform physiotherapy every day
6. There are changes in tonos in the right hand
Breathing breaths show changes for the better
8. The attending physician indicates a good general condition in relation to the treatment
9. We take the vitamins and pills according to your recommendation
10. Add the latest blood tests according to your request
11. After a positive impression of the doctors treating Amos in Israel and because of Amos's condition at the moment, it is desirable and worthwhile to repeat the treatment
We want to go back to a second treatment in China. At the same time, in Israel, we recommend that we buy the drug RADICUT EDARAVONE. We ask if there is no prevention to take this medicine along with your treatment.
Waiting for your reply

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